肝硬化腹水患者并发低钠血症84例的临床分析及防治体会

Clinical analysis and prevention and treatment of 84 cases of cirrhosis ascites complicated with hyponatremia

目的:探讨肝硬化腹水患者并发低钠血症的临床防治。方法:收治肝硬化腹水患者84例,回顾性分析其临床资料。结果:肝硬化的首次腹水患者与复发性腹水患者低钠血症发生率分别为23.5%、74%(P<0.01),无或轻度低钠血症患者与中、重度低钠血症患者在肝性脑病、肝肾综合征发生率、死亡率等方面差异亦有统计学意义(P<0.01)。结论:低钠血症是肝硬化腹水患者最常见的电解质紊乱之一,随着腹水复发次数的增多,低钠血症发生率越高,低钠的程度越重,预后越差,病死率越高,应提早预防和合理治疗。

Objective:To explore the clinical prevention and treatment of cirrhosis ascites complicated with hyponatremia.Methods:84patients with cirrhosis ascites were selected.The clinical data were retrospectively analyzed.Results:The incidence of hyponatremia in cirrhotic patients with first ascites and recurrent ascites was23.5%and74%respectively(P<0.01).The incidence of hepatic encephalopathy,hepatorenal syndrome and mortality between patients with no or mild hyponatremia and patients with moderate and severe hyponatremia were significantly different(P<0.01).Conclusion:Hyponatremia was one of the most common electrolyte disturbances in cirrhotic patients with ascites.With the increase in the number of ascites recurrence,the incidence of hyponatremia was higher,the degree of low sodium was heavier,the prognosis was worse,and the mortality rate was higher.We should carry out early prevention and reasonable treatment.